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Do Family Dynamics Affect Oral Health?

By Elyse Bloom

September 28, 2012

What does mental health have to do with dental health?

More than most think, according to Richard Heyman and Amy Smith Slep, psychologists who co-direct the Family Translational Research Group within the Department of Cariology and Comprehensive Care at the NYU College of Dentistry.

Heyman and Slep are part of a growing trend among dentists trying to understand how psychological factors affect oral health, especially when it comes to explaining causes of early childhood caries.

“There is a major change happening in our beliefs about the impact of psychological factors on both patient behaviors and on the biology of oral health,” says Mark Wolff, professor and chair of the Department of Cariology and Comprehensive Care and associate dean for predoctoral clinical education. “We need to ask how psychological events relate to tooth decay.”

Many factors contribute to the intransigence of early childhood caries. They include lack of parental education or acceptance of caries as normal, lack of access to dental care, and poor insurance coverage. However, until now, family dynamics have not been explored systematically as a contributor to oral health.

“There are two hypotheses about how oral health is affected by parental discord,” Heyman says. “First, lax supervision of children, as an outgrowth of discord, directly impacts children eating sugary cereals and beverages, and not brushing. The second is a biological response. There is strong research showing that family conflict and stress affect the immune system.”

“Lax parenting may be an even stronger influence on tooth decay than violent behavior,” says Wolff.

Now, Heyman’s and Slep’s group, together with Wolff and the College of Dentistry’s Ananda Dasanayake, professor of epidemiology and health promotion, are turning their findings into action, developing an intervention for couples where discord may impact the oral health of their very young children. The new project is the first to intervene with new parents on multiple levels to prevent childhood caries, and takes place over eight sessions, timed to intersect with the developmental stages of their infant, from 3-12 months. This covers the period of tooth eruption and transition to recommended dental visits, as well as both the newborn and toddler periods.

To examine the impact on oral health, dental exams will be performed on the children at 15 months, and researchers will look directly for early childhood caries as well as contributing factors such as bacteria and saliva hormones related to stress.